Obstacles to compassion-giving among nursing and midwifery managers: an international study.

AIM: To explore nursing and midwifery managers' views regarding obstacles to compassion-giving across country cultures. BACKGROUND: The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. Furthermore, evidence on how cultural factors hinder the expression of compassion among nursing and midwifery managers is lacking. METHODS: Cross-sectional, exploratory, international online survey involving 1 217 participants from 17 countries. Managers' responses on open-ended questions related to barriers for providing compassion were entered and thematically analysed through NVivo. RESULTS: Three key themes related to compassion-giving obstacles emerged across countries: 1. related to the managers' personal characteristics and experiences; 2. system-related; and 3. staff-related. CONCLUSIONS: Obstacles to compassion-giving among managers vary across countries. An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important. IMPLICATIONS FOR NURSING PRACTICE AND POLICY: Nursing mangers should wisely use their power by adopting leadership styles that promote culturally competent and compassionate workplaces with respect for human rights. Policymakers should identify training and mentoring needs to enable the development of managers' practical wisdom. Appropriate national and international policies should facilitate the establishment of standards and guidelines for compassionate leadership, in the face of distorted organizational cultures and system-related obstacles to compassion-giving.

Stack of two III-nitride laser diodes interconnected by a tunnel junction.

We demonstrate a stack of two III-nitride laser diodes (LDs) interconnected by a tunnel junction grown by plasma-assisted molecular beam epitaxy. Hydrogen-free growth is used to obtain as-grown p-type conductivity essential for buried tunnel junctions (TJ). We show the impact of the design of tunnel junction. In particular, we show that, apart from the beneficial piezoelectric polarization inside the TJ, heavy doping reduces the differential resistivity even further. The device starts to lase at a wavelength of 459 nm with a slope efficiency (SE) of 0.7 W/A followed by lasing at 456 nm from the second active region doubling the total SE to 1.4 W/A. This demonstration opens new possibilities for the fabrication of stacks of ultraviolet and visible high power pulsed III-nitride LD.

International study on nurses' views and experiences of compassion.

BACKGROUND: Compassion is considered the cornerstone of nursing practice. However, the recent failures in delivering high-quality compassionate nursing care in the UK's National Health Service have brought the topic of compassion to the attention of the public, service providers, policy makers and academics. AIM: The aim of this study was to explore the nurses' views and experiences of a number of compassion-related issues in nursing and describe similarities and differences at an international level as well as from the different nursing roles of the participating nurses. METHODS: An exploratory, cross-sectional descriptive study, using the International Online Compassion Questionnaire. A total of 1323 nurses from 15 countries completed the questionnaire. RESULTS: The majority of participants (59.5%) defined compassion as "Deep awareness of the suffering of others and wish to alleviate it" but definitions of compassion varied by country. Of participants, 69.6% thought compassion was very important in nursing and more than half (59.6%) of them argued that compassion could be taught. However, only 26.8% reported that the correct amount and level of teaching is provided. The majority of the participants (82.6%) stated that their patients prefer knowledgeable nurses with good interpersonal skills. Only 4.3% noted that they are receiving compassion from their managers. A significant relationship was found between nurses' experiences of compassion and their views about teaching of compassion. CONCLUSION: Our study is unique in identifying the views and experiences of nurses from 15 different countries worldwide. The findings reveal that compassion is neither addressed adequately in nursing education nor supported in the practice environment by managers. LIMITATIONS: Self-report bias was inherent to our survey study design. Furthermore, the individual cultural differences and similarities in the findings are difficult to extrapolate owing to the fact that our analysis was at country level, as well as at the level of the participating nurses. IMPLICATIONS FOR NURSING POLICY: Understanding the influence of culture on nurses' views about compassion is critical in the current multicultural healthcare environment and merits further research. This will potentially drive changes in nursing education (ensuring that compassion is taught to nurses) and in the way healthcare leaders and managers foster a compassionate culture within their organizations (e.g. by leading by example and compassionate to their staff).

Views about perceived training needs of health care professionals in relation to socially assistive robots: an international online survey.

BACKGROUND: As Artificial Intelligence and social robots are increasingly used in health and social care, it is imperative to explore the training needs of the workforce, factoring in their cultural background. OBJECTIVES: Explore views on perceived training needs among professionals around the world and how these related to country cultures. DESIGN: Cross-sectional, descriptive, mixed-methods international online survey. METHODS: Descriptive statistical analysis explored the ranking across countries and relationships with three Hofstede cultural dimensions. Thematic analysis was conducted on the open-ended text responses. RESULTS: A sample of N = 1284 participants from eighteen countries. Knowing the capabilities of the robots was ranked as the top training need across all participating countries and this was also reflected in the thematic analysis. Participants' culture, expressed through three Hofstede's dimensions, revealed statistically significant ranking differences. CONCLUSIONS: Future research should further explore other factors such as the level of digital maturity of the workplace. IMPACT STATEMENT: Training needs of health and social care staff to use robotics are fast growing and preparation should factor in patient safety and be based on the principles of person- and culture-centred care.

Extreme ultraviolet interferometry of warm dense matter in laser plasmas.

We demonstrate that interferometric probing with extreme ultraviolet (EUV) laser light enables determination of the degree of ionization of the "warm dense matter" produced between the critical and ablation surfaces of laser plasmas. Interferometry has been utilized to measure both transmission and phase information for an EUV laser beam at the photon energy of 58.5 eV, probing longitudinally through laser-irradiated plastic (parylene-N) targets (thickness 350 nm) irradiated by a 300 ps duration pulse of wavelength 438 nm and peak irradiance 10(12) W cm(-2). The transmission of the EUV probe beam provides a measure of the rate of target ablation, as ablated plasma becomes close to transparent when the photon energy is less than the ionization energy of the predominant ion species. We show that refractive indices η below the solid parylene N (η(solid) = 0.946) and expected plasma values are produced in the warm dense plasma created by laser irradiation due to bound-free absorption in C(+).

A review of selected anti-tumour therapeutic agents and reasons for multidrug resistance occurrence.

It is assumed that proteins from the ABC family (i.e., glycoprotein P (Pgp)) and a multidrug resistance associated protein (MRP) play a main role in the occurrence of multidrug resistance (MDR) in tumour cells. Other factors that influence the rise of MDR are mechanisms connected with change in the effectiveness of the glutathione cycle and with decrease in expression of topoisomerases I and II. The aim of this review is to characterize drugs applied in anti-tumour therapy and to describe the present state of knowledge concerning the mechanisms of MDR occurrence, as well as the pharmacological agents applied in reducing this phenomenon.

[The ability of modifying cognitive deficits in the area of social functioning in chronic schizophrenic patients]. / Mozliwosc modyfikowania deficytów poznawczych obserwowanych w obszarze funkcjonowania spolecznego u osób przewlekle chorych na schizofrenie.

The paper concerns the effectiveness of rehabilitation of chronically ill schizophrenic patients who participate in social skills training. The assumption was that the participation in a four-month training programme (as authored by R. P. Liberman) will improve emotional problem solving, ability to keep in norms and conflict solving as well as the ability of cause-effect thinking. 100 schizophrenic patients and their families participated in the study. Half of those studied participated in the social skills training programme and the half who did not, were the control group. The subjects were examined twice in the four months. The following tools were used: "Means Ends Problem Solving" by Platt and Spivack, "PANSS" by Kay and Fiszbein, "Social-demographic questionnaire". Before the study period the groups did not vary much in the aspect of interpersonal social skills solving. After the training, the participants benefited significantly in the effectiveness of their problem solving and other criteria improved as well. It was concluded that the study of a group of 100 chronic schizophrenic patients who participated in a four month social skills training programme has a significant effect on social skills problem solving. The improvement of those skills consisted of: interpersonal and emotional problem solving, prediction of the consequences of one's actions, cause-effect thinking and alternative thinking.

[Nurses as leaders of medication management training module]. / Rola pielegniarek w prowadzeniu treningu aktywnego udzialu chorych we wlasnej farmakoterapii.

In the group of 71 schizophrenic patients the connection between therapist profession (psychiatrist/nurse) and patients' gains concerning medication management was examined. Nurses were as well efficient as psychiatrists as the leaders of behavioral training and nearly as well efficient in conducting educational classes.

[Teaching schizophrenic patients self-care skills]. / Uczenie pacjentów chorych na schizofrenie umiejetnosci samoobslugi.

The level of knowledge and skills on self-care abilities has been examined among the group of 30 long-term patients suffering from schizophrenia. The research has been made four times during the period of 18 months after the training session had been completed. The final results show that three months duration of the training session exerts influence on the progress in learning and change of the view point. However, little change is observed as regards the daily functioning of patients.

Coulomb excitation of neutron-rich Zn isotopes: first observation of the 2(1)+ state in 80Zn.

Neutron-rich, radioactive Zn isotopes were investigated at the Radioactive Ion Beam facility REX-ISOLDE (CERN) using low-energy Coulomb excitation. The energy of the 2(1)+ state in 78Zn could be firmly established and for the first time the 2+ --> 0(1)+ transition in 80Zn was observed at 1492(1) keV. B(E2,2(1)+ --> 0(1)+) values were extracted for (74,76,78,80)Zn and compared to large scale shell model calculations. With only two protons outside the Z=28 proton core, 80Zn is the lightest N=50 isotone for which spectroscopic information has been obtained to date. Two sets of advanced shell model calculations reproduce the observed B(E2) systematics. The results for N=50 isotones indicate a good N=50 shell closure and a strong Z=28 proton core polarization. The new results serve as benchmarks to establish theoretical models, predicting the nuclear properties of the doubly magic nucleus 78Ni.

Association of collagen type I alpha1 gene polymorphism with bone density in survivors of childhood cancer--preliminary report.

A candidate gene, involved in the regulation of bone mass is the COLIA1 gene encoding type I collagen, the major protein of bone matrix. The disease per se, the age of its onset and treatment options might exert an impact on bone mineralization in survivors of childhood malignancy. We examined possible allelic influences of COLIA1 gene polymorphism on BMI, BMD spine and total body in 41 survivors (15 girls) of childhood cancer (the mean age 8.9 years). Genotype distribution was 33 (80.5%) SS and 8 (19.5%) Ss. There were no differences in SDS BMD and SDS BMI between patients with SS and Ss genotype. A tendency towards lower SDS values of BMD spine and BMI was observed (not significant). In conclusion, our preliminary observations suggest that COLIA1 genotype may affect bone accrual in a population treated for childhood cancer. Further investigations in a greater population are needed.

Oscillations of cerebrovascular resistance throughout the menstrual cycle in healthy women.

OBJECTIVES: Increased concentration of endogenous estrogen during a typical menstrual cycle has been shown to correlate with augmentation of blood flow through the internal carotid arteries (ICAs), which may be related to changes in vascular resistance within the brain. In this study we investigated the effects of endogenous estrogen and progesterone on cerebrovascular impedance in young healthy women. METHODS: The blood flow in the ICA and the common (CCA) and external (ECA) carotid arteries was studied with duplex Doppler sonography. The resistance index (RI) was determined and correlated with plasma 17beta-estradiol concentration in 14 young healthy women throughout their menstrual cycle. RESULTS: The concentration of 17beta-estradiol increased in the follicular phase of the cycle and reached a peak on day 14, whereas concentration of progesterone remained low. Along with an increase in estrogen concentration, the ICA RI had decreased from its initial level on average by 9.2% on day 13 and by 6.7% on day 14 (P < 0.05). In contrast, the trend of the ECA RI was to increase during the peak of estrogen concentration. There were no significant changes in the CCA RI or in the systolic blood pressure, heart rate, hematocrit and hemoglobin concentration through the menstrual cycle. CONCLUSIONS: Estrogen-related augmentation of blood flow through the ICA is caused mainly by decreased cerebrovascular impedance, as shown by a decrease in the ICA RI. These changes in RI suggest that estrogen influences cerebral impedance mainly by altering the resistance of cerebral microvasculature.

Magnetic moment of the fragmentation-aligned 61Fe (9/2(+)) isomer.

We report on the g factor measurement of an isomer in the neutron-rich (61)(26)Fe (E(*)=861 keV and T(1/2)=239(5) ns). The isomer was produced and spin aligned via a projectile-fragmentation reaction at intermediate energy, the time dependent perturbed angular distribution method being used for the measurement of the g factor. For the first time, due to significant improvements of the experimental technique, an appreciable residual alignment of the nuclear spin ensemble has been observed, allowing a precise determination of its g factor, including the sign: g=-0.229(2). In this way we open the possibility to study moments of very neutron-rich short-lived isomers, not accessible via other production and spin-orientation methods.